Felodipine Reduces the Absorption of Theophylline in Man

Ten healthy male volunteers (mean age 26 years) received 200 mg theophylline aminopropanol orally 8-hourly for 4 days, followed by 5 mg felodipine 8-hourly for 6 days, and then the combination of oral felodipine and theophylline for a further 4 days. Plasma concentrations of theophylline and felodipine were determined, and theophylline and its metabolites in urine were also measured. Felodipine led to a reduction in the plasma AUC of theophylline of 18.3%. The metabolic and renal clearances of theophylline remained unchanged, but the total recovery of theophylline-derived products was significantly reduced during felodipine treatment. No change in felodipine pharmacokinetics was observed during simultaneous treatment with theophylline. Compared to theophylline treatment alone, the diastolic blood pressure was significantly reduced during felodipine treatment alone and in combination with theophylline. It is concluded that felodipine slightly but significantly lowered the plasma theophylline concentration by interfering with its absorption. The interaction in most instances would probably be of minor clinical consequence.